LIGHTHOUSE RECOVERY CENTER – NPI #1386871853
Substance Abuse Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

LIGHTHOUSE RECOVERY CENTER is a substance abuse rehabilitation facility located in MIDVALE, UT. NPPES has assigned the NPI number 1386871853 to LIGHTHOUSE RECOVERY CENTER on June 11, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LIGHTHOUSE RECOVERY CENTER” is a dba name, the actual legal business name for this organization is MYSTIC MOTION INC. The primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LIGHTHOUSE RECOVERY CENTER below.

NPI Profile for
MYSTIC MOTION INC

NPI Number
1386871853
Enumeration Date

(about 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MYSTIC MOTION INC
Doing Business As (dba): LIGHTHOUSE RECOVERY CENTER
Primary location
7602 SOUTH MAIN STREET
MIDVALE, UT 84047
Phone: (801) 631-7122 Fax: (877) 840-9122
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
BRET HINER
PRESIDENT
Phone: (801) 631-7122
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
324500000X
- Substance Abuse Rehabilitation Facility (Primary)
UT 15350

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.